Endoscopic reposable surgical clip applier

ABSTRACT

A hub assembly for use with an endoscopic assembly of a reposable surgical clip applier includes an outer housing defining a channel therethrough, a driver gear slidably disposed within the channel, a transmission gear slidably and rotatably supported within the channel, and a display gear slidably and rotatably supported within the channel. Each of the driver gear, transmission gear, and display gear is configured for reciprocal movement within the channel. Distal advancement of the driver gear causes a corresponding distal advancement of the transmission gear and distal advancement of the transmission gear causes a corresponding distal advancement of the display gear. The transmission gear is caused to the rotated in a first direction during each distal advancement of the driver gear and the display gear is caused to be rotated in the first direction during a predetermined distal advancement of the transmission gear.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of and priority to U.S. ProvisionalPatent Application No. 62/545,508 filed Aug. 15, 2017, the entiredisclosure of which is incorporated by reference herein.

BACKGROUND Technical Field

This disclosure relates to surgical clip appliers. More particularly,the present disclosure relates to endoscopic reposable surgical clipappliers having a reusable handle assembly, at least one reusable shaftassembly, and at least one disposable clip cartridge assembly.

Description of Related Art

Endoscopic surgical clip appliers are used for a number of distinct anduseful surgical procedures. In the case of a laparoscopic surgicalprocedure, access to the interior of an abdomen is achieved throughnarrow tubes or cannulas inserted through a small entrance incision inthe skin. Minimally invasive procedures performed elsewhere in the bodyare often generally referred to as endoscopic procedures. Typically, atube or cannula device is extended into the patient's body through theentrance incision to provide an access port. The port allows the surgeonto insert a number of different surgical instruments therethrough usinga trocar and for performing surgical procedures far removed from theincision.

During a majority of these procedures, the surgeon must often terminatethe flow of blood or another fluid through one or more vessels. Thesurgeon will often use a particular endoscopic surgical clip applier toapply a surgical clip to a blood vessel or another duct to prevent theflow of body fluids therethrough during the procedure.

Endoscopic surgical clip appliers having various sizes (e.g.,diameters), that are configured to apply a variety of diverse surgicalclips, are known in the art, and which are capable of applying a singleor multiple surgical clips during an entry to the body cavity. Suchsurgical clips are typically fabricated from a biocompatible materialand are usually compressed over a vessel. Once applied to the vessel,the compressed surgical clip terminates the flow of fluid therethrough.

During endoscopic or laparoscopic procedures it may be desirable and/ornecessary to use different size surgical clips or different configuredsurgical clips depending on the underlying tissue or vessels to beligated. In order to reduce overall costs of an endoscopic surgical clipapplier, it is desirable for a single endoscopic surgical clip applierto be loadable with and capable of firing different size surgical clipsas needed.

Accordingly, a need exists for endoscopic surgical clip appliers thatinclude reusable handle assemblies, reusable shaft assemblies, anddisposable clip cartridge assemblies, with each clip cartridge assemblybeing loaded with a particularly sized clip (e.g., relatively small,relatively medium, or relatively large).

SUMMARY

The present disclosure relates to reposable endoscopic surgical clipappliers.

According to an aspect of the present disclosure, a hub assembly for usewith an endoscopic assembly of a reposable surgical clip applier isprovided. The hub assembly includes an outer housing defining proximaland distal end surfaces which define a channel therethrough, a drivergear slidably supported within the channel, a transmission gear slidablyand rotatably supported within the channel, and a display gear slidablyand rotatably supported within the channel. Each of the driver gear,transmission gear, and display gear is configured for reciprocalmovement within the channel. Distal advancement of the driver gearcauses a corresponding distal advancement of the transmission gear anddistal advancement of the transmission gear causes a correspondingdistal advancement of the display gear. The transmission gear is causedto be rotated in a first direction during each distal advancement of thedriver gear and the display gear is caused to be rotated in a seconddirection during a predetermined distal advancement of the transmissiongear.

In aspects, a portion of the channel may define a pair of opposed bosseshaving an upper portion and a lower portion.

In certain aspects, the driver gear may define a plurality of teeth on adistal portion thereof.

In other aspects, the transmission gear may define a plurality of teethon a proximal portion thereof, the plurality of teeth configured toselectively engage the plurality of teeth of the driver gear to causerotation of the transmission gear in the first direction duringengagement therewith.

In certain aspects, the plurality of teeth of the transmission gear maybe configured to engage the upper portion of the pair of opposed bossesto further rotate the transmission gear in the first direction.

In aspects, the transmission gear may define a pair of opposed teeth ona distal portion thereof.

In other aspects, the display gear may define a first plurality of teethon a proximal portion thereof configured to engage the lower portion ofthe pair of opposed bosses. Engagement between the first plurality ofteeth and the lower portion of the pair of opposed bosses may causerotation of the display gear in the second direction during apredetermined proximal retraction of the display gear corresponding tothe predetermined distal advancement of the transmission gear.

In certain aspects, the display gear may define a second plurality ofteeth on the proximal portion thereof. The second plurality of teeth maybe disposed radially inward of predetermined teeth of the firstplurality of teeth and configured to selectively engage the pair ofopposed teeth of the transmission gear.

In other aspects, the second plurality of teeth may define a pair ofteeth corresponding to the pair of teeth of the transmission gear.

In certain aspects, an outer surface of the display gear may define aplurality of portions having a contrasting color.

In aspects, the outer housing may define a plurality of windowstherethrough. A greater portion of each of the plurality of portions mayhave a contrasting color that is visible through each window of theplurality of windows after each predetermined distal advancement of thetransmission gear.

In certain aspects, each engagement of the plurality of teeth of thedriver gear with the plurality of teeth of the transmission gear maycause the transmission gear to rotate 1/24^(th) of a rotation in thefirst direction.

In aspects, each engagement of the plurality of teeth of thetransmission gear with the upper portion of the pair of opposed bossesmay cause the transmission gear to rotate a further 1/24^(th) of arotation in the first direction.

In other aspects, predetermined distal advancement of the transmissiongear may correspond to ½ of a rotation of the transmission gear.

In aspects, the display gear may be configured to rotate 1/24^(th) of arotation in the second direction during engagement of the secondplurality of teeth of the display gear with the pair of opposed teeth ofthe transmission gear.

In certain aspects, the first plurality of teeth of the display gear mayengage the lower portion of the pair of opposed bosses during proximaltranslation thereof after the predetermined distal advancement of thetransmission gear. Engagement of the first plurality of teeth of thedisplay gear and the lower portion of the pair of opposed bosses maycause the display gear to rotate a further 1/24^(th) of a rotation inthe second direction.

In other aspects, the hub assembly may further include a display gearbiasing element interposed between a distal surface of the display gearand a proximal facing surface defined by the channel. The display gearbiasing element may be configured to bias the display gear in a proximaldirection.

In certain aspects, the hub assembly may further include a spindletranslatably supported within the channel. The spindle may be inselective communication with the driver gear.

In aspects, the hub assembly may further include an overstroke mechanismdisposed within a distal portion of the channel.

In certain aspects, the overstroke mechanism may be in mechanicalcommunication with the spindle. The overstroke mechanism may beconfigured to permit an overextension of the spindle and inhibit damageto a pair of jaws associated with the endoscopic assembly.

BRIEF DESCRIPTION OF THE DRAWINGS

A particular embodiment of a surgical clip applier is disclosed hereinwith reference to the drawings wherein:

FIG. 1 is a perspective view of a reposable endoscopic surgical clipapplier, according to the present disclosure including a reusable handleassembly, and a first endoscopic assembly and a second endoscopicassembly each selectively connectable to the handle assembly;

FIG. 2 is perspective view of the reposable endoscopic surgical clipapplier including the reusable handle assembly and the first endoscopicassembly connected thereto;

FIG. 3 is a perspective view of the handle assembly with at least ahousing half-section removed therefrom;

FIG. 4 is a perspective view, with parts separated, of the handleassembly of FIGS. 1-3;

FIG. 5 is an enlarged perspective view of the indicated area of detailof FIG. 4, illustrating a pawl switch and a pawl actuator of the handleassembly of FIG. 1;

FIG. 6 is a further perspective view of the pawl switch of FIG. 5;

FIG. 7 is a further perspective view of the pawl actuator of FIG. 5;

FIGS. 8-9 are various perspective views of the pawl switch and the pawlactuator of the handle assembly, shown in operation with the pawl switchin an un-actuated condition and the pawl actuator engaged with a pawl ofa ratchet assembly;

FIG. 10 is a top plan view of the pawl switch and the pawl actuator ofthe handle assembly, shown in operation with the pawl switch in theun-actuated condition and the pawl actuator engaged from the pawl of theratchet assembly;

FIG. 11 is a transverse, cross-sectional view of the handle assembly ofFIG. 1 as taken through 11-11 of FIG. 1, illustrating the pawl switch inan actuated condition;

FIGS. 12-13 are various perspective views of the pawl switch and thepawl actuator of the handle assembly, shown in operation with the pawlswitch in the actuated condition and the pawl actuator disengaged fromthe pawl of the ratchet assembly;

FIG. 14 is a top plan view of the pawl switch and the pawl actuator ofthe handle assembly, shown in operation with the pawl switch in theactuated condition and the pawl actuator disengaged from the pawl of theratchet assembly;

FIG. 15 is a perspective view, with parts separated, of the firstendoscopic assembly of FIG. 1;

FIG. 16 is a top, plan view of the first endoscopic assembly of FIGS. 1and 15;

FIG. 17 is a transverse, cross-sectional view of the first endoscopicassembly of FIGS. 1 and 15-16, as taken through 17-17 of FIG. 16;

FIG. 18 is a perspective view illustrating an initial connection of thehandle assembly and the first endoscopic assembly;

FIG. 19 is a longitudinal, transverse cross-sectional view illustratingthe initial connection of the handle assembly and the first endoscopicassembly;

FIG. 20 is an enlarged view of the indicated area of detail of FIG. 19;

FIG. 21 is a longitudinal, transverse cross-sectional view illustratinga complete connection of the handle assembly and the first endoscopicassembly;

FIG. 22 is an enlarged view of the indicated area of detail of FIG. 21;

FIG. 23 is a longitudinal, transverse cross-sectional view illustratingan initial actuation of the handle assembly with the first endoscopicassembly connected thereto;

FIG. 24 is an enlarged view of the indicated area of detail of FIG. 23;

FIG. 25 is a longitudinal, transverse cross-sectional view illustratinga complete actuation of the handle assembly with the first endoscopicassembly connected thereto;

FIG. 26 is perspective view of the reposable endoscopic surgical clipapplier including the reusable handle assembly and the second endoscopicassembly connected thereto;

FIG. 27 is a perspective view, with parts separated, of the secondendoscopic assembly of FIGS. 1 and 26;

FIG. 28 is a perspective view, with parts separated, of a shaft assemblyof the second endoscopic assembly;

FIG. 29 is a perspective view of the distal end of the shaft assembly ofthe second endoscopic assembly with an outer tube removed therefrom;

FIG. 30 is an enlarged view of the indicated area of detail of FIG. 29;

FIG. 31 is an enlarged view of the indicated area of detail of FIG. 29;

FIG. 32 is a perspective view of the distal end of the shaft assembly ofthe second endoscopic assembly with the outer tube and a pusher barremoved therefrom;

FIG. 33 is an enlarged view of the indicated area of detail of FIG. 32;

FIG. 34 is an enlarged view of the indicated area of detail of FIG. 32;

FIG. 35 is a perspective view of the distal end of the shaft assembly ofthe second endoscopic assembly with the outer tube, the pusher bar and aclip channel removed therefrom;

FIG. 36 is an enlarged view of the indicated area of detail of FIG. 35;

FIG. 37 is an enlarged view of the indicated area of detail of FIG. 35;

FIG. 38 is a perspective view of the distal end of the shaft assembly ofthe second endoscopic assembly with the outer tube, the pusher bar, theclip channel and a pair of jaws and a filler component removedtherefrom;

FIG. 39 is a perspective view of the distal end of the shaft assembly ofthe second endoscopic assembly with the outer tube, the pusher bar, theclip channel, the pair of jaws, the filler component, and a wedge plateremoved therefrom;

FIG. 40 is a longitudinal, transverse cross-sectional view illustratinga complete connection of the handle assembly and the second endoscopicassembly, prior to actuation of a trigger of the handle assembly;

FIG. 41 is a longitudinal, transverse cross-sectional view illustratinga complete actuation of the handle assembly with the second endoscopicassembly connected thereto;

FIG. 42 is a perspective view of another embodiment of an endoscopicassembly provided in accordance with the present disclosure;

FIG. 43 is a longitudinal, cross-sectional view of the endoscopicassembly of FIG. 42, as taken through 43-43 of FIG. 42;

FIG. 44 is a perspective view, with parts separated of the endoscopicassembly of FIG. 42;

FIG. 45 is a longitudinal, cross-sectional view of an outer housing ofthe endoscopic assembly of FIG. 42;

FIG. 46 is a perspective view of a cartridge cylinder of the endoscopicassembly of FIG. 42;

FIG. 47 is a perspective view of a spindle of the endoscopic assembly ofFIG. 42;

FIG. 48 is a perspective view of a display gear of the endoscopicassembly of FIG. 42;

FIG. 48A is a longitudinal, cross-sectional view of the display gear ofFIG. 48;

FIG. 49 is a rear view of the display gear of FIG. 48;

FIG. 50 is a perspective view of a transmission gear of the endoscopicassembly of FIG. 42;

FIG. 51 is a rear view of the transmission gear of FIG. 50;

FIG. 52 is a side view of a driver gear of the endoscopic assembly ofFIG. 42;

FIG. 52A is a longitudinal, cross-sectional view of the driver gear ofFIG. 52;

FIG. 53A is a front view of a lockout spring of the endoscopic assemblyof FIG. 42;

FIG. 53B is a perspective view of the lockout spring of FIG. 53A;

FIG. 54 is a longitudinal, cross-sectional view of the endoscopicassembly of FIG. 42, shown in a partially actuated position;

FIG. 55 is a longitudinal, cross-sectional view of the endoscopicassembly of FIG. 42, shown with the driver gear of FIG. 52 engaged withthe transmission gear of FIG. 50;

FIG. 56 is a longitudinal, cross-sectional view of the endoscopicassembly of FIG. 42, shown in a fully retracted position;

FIG. 57 is perspective, cross-sectional view of the endoscopic assemblyof FIG. 42, shown with the transmission gear of FIG. 50 engaging aportion of the outer housing of FIG. 45;

FIG. 58 is a longitudinal, cross-sectional view of the endoscopicassembly of FIG. 42, shown with the driver gear of FIG. 52 and thetransmission gear of FIG. 50 in a partially actuated position;

FIG. 59 is a perspective, cross-sectional view of the endoscopicassembly of FIG. 42, shown with the transmission gear of FIG. 50partially engaging the display gear of FIG. 48;

FIG. 60 is a longitudinal, cross-sectional view of the endoscopicassembly of FIG. 42, shown with the display gear of FIG. 48 engaging aportion of the outer housing of FIG. 45;

FIG. 61A is a side view of the endoscopic assembly of FIG. 42 shown witha portion of a shaded region of the display gear of FIG. 48 visible;

FIG. 61B is a side view of the endoscopic assembly of FIG. 42 shown witha greater portion of the shaded region of the display gear of FIG. 48visible;

FIG. 62 is a perspective, cross-sectional view of the endoscopicassembly of FIG. 42 showing the lockout spring of FIG. 53A engaging aportion of the spindle of FIG. 47;

FIG. 63 is a perspective view with parts separated of an overstrokemechanism for use with the endoscopic assembly of FIG. 42;

FIG. 64A is a side view of the overstroke mechanism of FIG. 63;

FIG. 64B is a longitudinal, cross-sectional view of the overstrokemechanism of FIG. 63 shown in an initial, unactuated position;

FIG. 64C is a longitudinal, cross-sectional view of the overstrokemechanism of FIG. 63 shown in a partially actuated position;

FIG. 64D is a longitudinal, cross-sectional view of the overstrokemechanism of FIG. 63 shown in a fully actuated position;

FIG. 64E is a side view of the overstroke mechanism of FIG. 63 shown ina fully actuated position; and

FIG. 65 is a schematic illustration of a robotic surgical systemconfigured for use in accordance with the present disclosure.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of reposable endoscopic surgical clip appliers, inaccordance with the present disclosure, will now be described in detailwith reference to the drawing figures wherein like reference numeralsidentify similar or identical structural elements. As shown in thedrawings and described throughout the following description, as istraditional when referring to relative positioning on a surgicalinstrument, the term “proximal” refers to the end of the apparatus whichis closer to the user and the term “distal” refers to the end of theapparatus which is further away from the user.

Referring now to FIGS. 1-29, an endoscopic surgical clip applier inaccordance with an embodiment of the present disclosure, and assembly ina particular configuration, is generally designated as 10. Surgical clipapplier 10 generally includes a reusable handle assembly or actuationassembly 100, at least one disposable or reusable endoscopic assembly200 selectively connectable to and extendable distally from handleassembly 100; and optionally at least one disposable surgical clipcartridge assembly (not shown) selectively loadable into a shaftassembly of a respective endoscopic assembly 200.

Briefly, the shaft assembly of endoscopic assembly 200 may have variousouter diameters such as, for example, about 5 mm or about 10 mm,depending on intended use. Further, the shaft assembly may have variousrelatively elongated or shortened lengths depending on intended use,such as, for example, in bariatric surgery. In one embodiment, inbariatric surgery, the shaft assembly may have a length of between about30 cm and about 40 cm. Further, the shaft assembly may be configured tofire and form a specific type of surgical clip, either individually ormultiply. However one skilled in the art should appreciate that theshaft assembly may have any length in excess of about 30 cm and thepresent disclosure is not limited to any of the above identifiedlengths.

In accordance with the present disclosure, as will be discussed ingreater detail below, an endoscopic assembly or a surgical clipcartridge assembly (not shown) may be loaded with a particularly sizedset of surgical clips (e.g., relatively small surgical clips, relativelymedium surgical clips, or relatively large surgical clips). It iscontemplated that clip cartridge assemblies may be configured to beselectively loaded into the shaft assembly of a respective endoscopicassembly 200, and to be actuated by the same or common handle assembly100, to fire and form the surgical clip(s) loaded therein ontounderlying tissue and/or vessels.

Referring now to FIGS. 1-14, handle assembly 100 of surgical clipapplier 10 is shown and will be described. Handle assembly 100 includesa housing 102 having a first or right side half-section 102 a and asecond or left side half-section 102 b. Housing 102 of handle assembly100 further includes or defines, as seen in FIGS. 3 and 4, a nose 102 c.Housing 102 of handle assembly 100 may be formed of a suitable plasticor thermoplastic material. It is further contemplated that housing 102of handle assembly 100 may be fabricated from stainless steel of thelike.

Handle assembly 100 includes a trigger 104 pivotably supported betweenright side half-section 102 a and left side half-section 102 b ofhousing 102. Trigger 104 is biased by a biasing member 104 a (e.g., areturn spring, compression spring or torsion spring) to an un-actuatedcondition. Specifically, biasing member 104 a (FIG. 4) acts on a featureof trigger 104 and on a feature of housing 102 to bias or urge trigger104 to the un-actuated condition. Trigger 104 includes a drive arm 104 bextending therefrom. Drive arm 104 b may be integrally formed therewithor may be separately and fixedly secured to trigger 104. Drive arm 104 bmay define a curved, radiused or filleted upper distal surface.

As illustrated in FIGS. 3, 4 and 8-14, trigger 104 supports or isprovided with at least one linear rack 152 of teeth 152 a of a ratchetassembly 150, as will be described in detail below.

With reference to FIGS. 3, 4, 11, handle assembly 100 includes a driveplunger 120 operatively connected to trigger 104. Specifically, driveplunger 120 is slidably supported within housing 102 and defines a pairof opposed, axially extending slots 120 a formed in an outer surfacethereof. Slots 120 a of drive plunger 120 are configured to slidablyengage or receive opposed tabs 102 d of housing 102. Drive plunger 120further defines a proximally extending trigger slot 120 b formed in aproximal portion thereof for operatively receiving drive arm 104 b oftrigger 104. Trigger slot 120 b defines a distal surface or wall 120 cagainst which a distal surface of drive arm 104 b of trigger 104contacts in order to distally advance drive plunger 120 during anactuation of trigger 104.

Drive plunger 120 further includes a tooth 120 d (FIG. 11) projectinginto trigger slot 120 b. Tooth 120 d projects substantially towardtrigger 104 and includes a distal surface or wall 120 d 1 (spacedproximally from distal surface or wall 120 c of drive plunder 120), anda proximal, angled wall 120 d 2 tapering to a relatively smaller heightin a proximal direction.

Drive plunger 120 additionally includes a tab or fin 120 e projectingfrom a surface thereof. Tab 120 e of drive plunger 120 may besubstantially aligned or in registration with tooth 120 d of driveplunger 120. Tab 120 e of drive plunger 120 may project in a directionsubstantially opposite to tooth 120 d of drive plunger 120 or to trigger104.

With reference to FIGS. 1-4 and 11, handle assembly 100 includes anendoscopic assembly release lever 130 pivotally supported on andconnected to housing 102 via a pivot pin 132. Pivot pin 132 is supportedin housing 102. Release lever 130 includes a proximal end 130 aextending proximally of pivot pin 132. Proximal end 130 a of releaselever 130 includes a wall 130 c dimensioned to extend toward a pawlswitch 140 of handle assembly 100, as will be described in greaterdetail below.

Release lever 130 includes a distal end 130 b extending distally ofpivot pin 132. Distal end 130 b of release lever 130 includes a catch ortooth 130 d projecting therefrom, in a direction towards drive plunger120. Catch 130 d may be located distal of drive plunger 120.

A biasing member 134, in the form of a leaf spring, may be providedwhich tends to bias distal end 130 b and catch 130 d of release lever130 towards drive plunger 120 of handle assembly 100, and tends to biasproximal end 130 a of release lever 130 away from pawl switch 140.Specifically, biasing member 134 tends to maintain catch 130 d ofrelease lever 130 in engagement with an engagement feature (e.g.,annular channel 212 c) of endoscopic assembly 200, as will be describedin greater detail below.

With reference to FIGS. 3, 4 and 11-14, as mentioned above, handleassembly 100 includes a ratchet assembly 150 supported within housing102. Ratchet assembly 150 includes, as also mentioned above, at leastone linear rack 152 of teeth 152 a supported on and projecting fromtrigger 104. Ratchet assembly 150 further includes a ratchet pawl 154pivotally connected to housing 102 by a pawl pin at a location whereinpawl 154 is in substantial operative engagement with rack 152. Ratchetassembly 150 further includes a pawl spring 156 configured andpositioned to bias pawl 154 into operative engagement with rack 152.Pawl spring 156 functions to maintain the tooth or teeth 154 a of pawl154 in engagement with teeth 152 a of rack 152, as well as to maintainpawl 154 in a rotated or canted position.

Pawl 154 is engagable with rack 152 to restrict longitudinal movement ofrack 152 and, in turn, trigger 104. In use, as trigger 104 is actuated(from a fully un-actuated position), rack 152 is also moved, intoengagement with pawl 154. Rack 152 has a length which allows pawl 154 toreverse and advance back over rack 152, when rack 152 changes betweenproximal or distal movement, as trigger 104 reaches a fully actuated orfully un-actuated position. The relative lengths and sizes of rack 152of ratchet assembly 150, trigger 104 and drive plunger 120 define astroke length of trigger 104, drive plunger 120 or handle assembly 100(e.g., a “full stroke”).

Turning now to FIGS. 1, 2, 4, 11 and 18, handle assembly 100 includes arotation knob 160 rotatably supported on nose 102 c of housing 102.Rotation knob 160 includes a central axial bore 160 a having an annulararray of longitudinally extending grooves 160 b (FIG. 18) formed in asurface thereof. Grooves 160 b of rotation knob 160 function as clockingand alignment features for the connection of endoscopic assembly 200with handle assembly 100. Rotation knob 160 further includes a pluralityof finger grip ribs 160 c projecting from an outer surface thereof.

With reference to FIGS. 3 and 4-14, handle assembly 100 further includesa pawl switch 140 and a pawl actuator 142 each pivotally supported inhousing 102. Pawl switch 140 is operatively connected to pawl actuator142 and is operable to selectively move pawl actuator 142 into or out ofengagement with pawl spring 156, and in turn pawl 154, of ratchetassembly 150 whereby pawl 154 may be selectively engaged by pawl spring156. In this manner, when pawl 154 is moved out of engagement with pawlspring 156, trigger 104 is free to open and close as needed due to pawl154 having minimal blocking effect on rack 152 of ratchet assembly 150.As such, trigger 104 may be partially actuated (without having to befully actuated), and may be returnable to a fully un-actuated position.Such a feature permits the user to partially squeeze or actuate trigger104 for performing a cholangiogram procedure or the like.

Pawl switch 140 includes a finger lever 140 a projecting from housing102, whereby pawl switch 140 may be actuated by a finger of a user.Housing 102 of handle assembly 100 may be provided with guard walls 102d disposed on opposed sides of finger lever 140 a in order to inhibitinadvertent actuation of pawl switch 140. Pawl switch 140 is movable,upon actuation of finger lever 140 a, between a first position in whichratchet assembly 150 is “on” or “activated”, and a second position inwhich ratchet assembly 150 is “off” or “de-activated.” It iscontemplated that pawl switch 140, and in turn ratchet assembly 150,default to the first position.

Pawl switch 140 further includes a first flange 140 b projecting a firstdistance from a pivot point thereof, and a second flange 140 cprojecting a second distance from the pivot point thereof, wherein theprojection of the second flange 140 c is greater than the projection ofthe first flange 140 b. First flange 140 b of pawl switch 140 isselectively engagable by wall 130 c of proximal end 130 a of releaselever 130. In this manner, each time an endoscopic assembly 200 isattached to handle assembly 100, and release lever 130 is actuated, wall130 c of release lever 130 engages first flange 140 b of pawl switch 140to move pawl switch to the first position (FIGS. 19-22).

Pawl switch 140 also includes a ramp or camming surface 140 d projectingtherefrom which selectively engages a tab or finger 142 a of pawlactuator 142 to slidably move pawl actuator 142, and in turn pawl spring156, into and out of operative engagement/registration with/from pawl154.

Pawl actuator 142 is pivotally connected to housing 102 and operativelyconnected to pawl switch 140 such that actuation of pawl switch 140actuates pawl actuator 142. Pawl actuator 142 is slidably supported on apair of support pins 143 a, 143 b, and a biasing member 144 is providedto bias pawl actuator 142 against pawl switch 140. In operation, withreference to FIGS. 11-14, when pawl switch 140 is actuated to the secondposition, ramp or camming surface 140 d of pawl switch 140 acts on tab142 a of pawl actuator 142 to transversely slide pawl actuator 142 alongsupport pins 143 a, 143 b and move pawl spring 156 out of operativeengagement/registration with pawl 154, thereby disabling the operabilityof ratchet assembly 150. Also, as pawl actuator 142 is slid transverselyalong support pins 143 a, 143 b, pawl actuator 142 biases biasing member144.

Further in operation, with reference to FIGS. 8-10, when pawl switch 140is actuated to the first position, ramp or camming surface 140 d of pawlswitch 140 is moved to permit biasing member 144 to expand andtransversely slide pawl actuator 142 along support pins 143 a, 143 b,whereby pawl spring 156 is moved back into operativeengagement/registration with pawl 154, thereby enabling or re-enablingthe operability of ratchet assembly 150.

Turning now to FIGS. 1, 2, 16 and 17, an embodiment of an endoscopicassembly 200, of surgical clip applier 10, is shown and described.Endoscopic assembly 200 includes a hub assembly 210, a shaft assembly220 extending from hub assembly 210, and a pair of jaws 250 pivotallyconnected to a distal end of shaft assembly 220. It is contemplated thatendoscopic assembly 200 may be configured to close, fire or formsurgical clips similar to those shown and described in U.S. Pat. No.4,834,096, the entire content of which is incorporated herein byreference.

Hub assembly 210 functions as an adapter assembly which is configuredfor selective connection to rotation knob 160 and nose 102 c of housing102 of handle assembly 100. Hub assembly 210 includes an outer housing212 having a cylindrical outer profile. Outer housing 212 includes afirst or right side half section 212 a, and a second or left side halfsection 212 b. Outer housing 212 of hub assembly 210 defines an outerannular channel 212 c formed in an outer surface thereof, and at leastone (or an annular array) of axially extending ribs 212 d projectingfrom an outer surface thereof. Outer annular channel 212 c of outerhousing 212 of endoscopic assembly 200 is configured to receive catch130 d of release lever 130 of handle assembly 100 (FIGS. 19-22) whenendoscopic assembly 200 is coupled to handle assembly 100.

Ribs 212 d of outer housing 212 function as a clocking/alignment featureduring connection of endoscopic assembly 200 and handle assembly 100with one another, wherein ribs 212 d of outer housing 212 of endoscopicassembly 200 are radially and axially aligned with respective grooves160 b of rotation knob 160 of handle assembly 100. During connection ofendoscopic assembly 200 and handle assembly 100, ribs 212 d of outerhousing 212 of endoscopic assembly 200 are slidably received inrespective grooves 160 b of rotation knob 160 of handle assembly 100.

The connection of hub assembly 210 of endoscopic assembly 200 withrotation knob 160 of handle assembly 100 enables endoscopic assembly 200to rotate 360°, about a longitudinal axis thereof, relative to handleassembly 100.

Outer housing 212 of hub assembly 210 further defines an open proximalend 212 e configured to slidably receive a distal end of drive plunger120 of handle assembly 100, when endoscopic assembly 200 is coupled tohandle assembly 100 and/or when surgical clip applier 10 is fired.

As mentioned above, endoscopic assembly 200 includes a shaft assembly220 extending distally from hub assembly 210. Shaft assembly 220includes an elongate outer tube 222 having a proximal end 222 asupported and secured to outer housing 212 of hub assembly 210, a distalend 222 b projecting from outer housing 212 of hub assembly 210, and alumen 222 c (FIGS. 15 and 17) extending longitudinally therethrough.Distal end 222 b of outer tube 222 supports or defines an outer clevis222 d for pivotally supporting a pair of jaws 250, as will be describedin greater detail below.

Shaft assembly 220 further includes an inner shaft 224 slidablysupported within lumen 222 c of outer tube 222. Inner shaft 224 includesa proximal end 224 a projecting proximally from proximal end 222 a ofouter tube 222, and a distal end 224 b defining an inner clevis 224 cfor supporting a cam pin 224 d which engages camming slots 252 c, 254 cof a pair of jaws 250, as will be described in greater detail below.

With reference to FIGS. 15 and 17, hub assembly 210 includes a driveassembly 230 supported within outer housing 212 thereof. Drive assembly230 includes a cartridge cylinder 232 having a cup-like configuration,wherein cartridge cylinder 232 includes an annular wall 232 a, aproximal wall 232 b supported at and closing off a proximal end ofannular wall 232 a, an open distal end 232 c, and a cavity or bore 232 ddefined therewithin.

Drive assembly 230 also includes a cartridge plunger 234 slidablysupported within bore 232 d of cartridge cylinder 232. Cartridge plunger234 is fixedly supported on inner shaft 224, at the proximal end 224 athereof. Cartridge plunger 234 is sized and configured for slidablereceipt within bore 232 d of cartridge cylinder 232 of drive assembly230. A ring, flange or the like 235 may be fixedly supported at a distalend of bore 232 d of cartridge cylinder 232, through which proximal end224 a of cartridge plunger 234 extends and which functions to maintaincartridge plunger 234 within bore 232 d of cartridge cylinder 232.

Drive assembly 230 includes a first biasing member 236 (e.g., acompression spring) disposed within bore 232 d of cartridge cylinder232. Specifically, first biasing member 236 is interposed betweenproximal wall 232 b of cartridge cylinder 232 and a proximal surface ofcartridge plunger 234. First biasing member 236 has a first springconstant “K1” which is relatively more firm or more stiff, as comparedto a second spring constant “K2” of a second biasing member 238, as isdescribed in detail below.

Drive assembly 230 further includes a second biasing member 238 (e.g., acompression spring) supported on proximal end 224 a of inner shaft 224.Specifically, second biasing member 238 is interposed between a proximalflange 222 d of outer tube 222 and a distal surface of cartridge plunger234. Second biasing member 238 has a second spring constant “K2” whichis relatively less firm or less stiff, as compared to the first springconstant “K1” of first biasing member 236.

As illustrated in FIGS. 15 and 17, endoscopic assembly 200 includes apair of jaws 250 pivotally supported in a clevis 222 d at distal end 222b of outer tube 222 by a pivot pin 256. The pair of jaws 250 includes afirst jaw 252 and a second jaw 254. Each jaw 252, 254 includes arespective proximal end 252 a, 254 a, and a respective distal end 252 b,254 b, wherein proximal ends 252 a, 254 a and distal ends 252 b, 254 bof jaws 252, 254 are pivotable about pivot pin 256. Each proximal end252 a, 254 a of respective jaws 252, 254 defines a cam slot 252 c, 254 ctherein which is sized and configured to receive cam pin 224 d of innershaft 224. In use, as inner shaft 224 is axially displaced relative toouter shaft 222, inner shaft 224 translated cam pin 224 d thereofthrough cam slot 252 c, 254 c of jaws 252, 254 to thereby open or closethe pair of jaws 250.

When the pair of jaws 250 are in an open position, and a new, unformedor open surgical clip (not shown) is located or loaded within the distalends 252 b, 254 b of jaws 252, 254 of the pair of jaws 250, as innershaft 224 is moved distally relative to outer shaft 222, cam pin 224 dis translated through cam slots 252 c, 254 c of jaws 252, 254. As campin 224 d is translated through cam slots 252 c, 254 c of jaws 252, 254the distal ends 252 b, 254 b of jaws 252, 254 are moved to the closed orapproximated position to close and/or form the surgical clip located orloaded therewithin.

The dimensions of jaws 252, 254 and of cam slots 252 c, 254 c of jaws252, 254 determines an overall length required to move jaws 252, 254from a fully open position to a fully closed position, defining aclosure stroke length of the pair of jaws 250.

With reference now to FIGS. 19-25, an operation or firing of surgicalclip applier 10, including endoscopic assembly 200 operatively connectedto handle assembly 100, is shown and described. With endoscopic assembly200 operatively connected to handle assembly 100, and with a new,unformed or open surgical clip (not shown) is located or loaded withinthe distal ends 252 b, 254 b of jaws 252, 254 of the pair of jaws 250,as trigger 104 of handle assembly 100 is actuated drive bar 104 b oftrigger 104 acts on drive plunger 120 to distally advance drive plunger120. As trigger 104 is actuated, pawl 154 of ratchet assembly 150 beginsto engage rack 152 thereof. With pawl 154 engaged with rack 152, trigger104 may not return to a fully unactuated position until trigger 104completes a full actuation or stroke thereof.

As drive plunger 120 is distally advanced, a distal end of drive plunger120 presses against proximal wall 232 b of cartridge cylinder 232 ofdrive assembly 230 of endoscopic assembly 200 to distally advancecartridge cylinder 232. Due to first spring constant “K1” of firstbiasing member 236 being larger or greater than second spring constant“K2” of second biasing member 238, as cartridge cylinder 232 is advanceddistally, cartridge cylinder 232 distally advances first biasing member236, which in turn acts on cartridge plunger 234 to distally advancecartridge plunger 234. As cartridge plunger 234 is distally advanced,cartridge plunger 234 distally advances inner shaft 224 relative toouter shaft 222. Being that second biasing member 238 is interposedbetween proximal flange 222 d of outer tube 222 and distal surface ofcartridge plunger 234, as cartridge plunger 234 is distally advanced,cartridge plunger 234 also compresses second biasing member 238.

As inner shaft 224 is distally advanced relative to outer shaft 222,inner shaft 224 distally advances cam pin 224 d through cam slot 252 c,254 c of jaws 252, 254 to close the pair of jaws 250 and to close and/orform the surgical clip (not shown) loaded within the pair of jaws 250.Cam pin 224 d of inner shaft 224 is advanced distally until cam pin 224d reaches an end of cam slots 252 c, 254 c of jaws 252, 254 of the pairof jaws 250 and/or until the distal ends 252 b, 254 b of jaws 252, 254of the pair of jaws 250 are fully approximated against one another(e.g., in contact with one another or fully closed on the surgical clip(not shown)), whereby cam pin 224 d may not have reached the end of camslots 252 c, 254 c of jaws 252, 254. This position may be considered ahard stop of the pair of jaws 250. The axial distance that cam pin 224 dhas traveled from a proximal-most position thereof to when cam pin 224 dreaches the end of cam slots 252 c, 254 c of jaws 252, 254 or when thedistal ends 252 b, 254 b of jaws 252, 254 of the pair of jaws 250 arefully approximated against one another, may also define the closurestroke length of the pair of jaw 250.

When the pair of jaws 250 have reached the hard stop, or when the campin 224 d has reached an end of the closure stroke length, pawl 154 ofratchet assembly 150 of handle assembly 100 may not have cleared rack152 thereof, and thus blocks or prevents trigger 104 from returning to afully unactuated position thereof. Since the pair of jaws 250 cannotclose any further, and since cam pin 224 d cannot be advanced distallyany further, inner shaft 222 is also stopped from further distaladvancement. However, as mentioned above, in order to return trigger 104to the fully unactuated position, trigger 104 must first complete thefull actuation stroke thereof. As such, as trigger 104 is furtheractuated to complete the full stroke thereof, as drive plunger 120 iscontinued to be driven distally, the distal end of drive plunger 120continues to press against proximal wall 232 b of cartridge cylinder 232of drive assembly 230 of endoscopic assembly 200 to continue to distallyadvance cartridge cylinder 232.

With inner shaft 222, and in turn cartridge plunger 234, stopped fromany further distal advancement, as cartridge cylinder 232 is continuedto be advanced distally, cartridge cylinder 232 begins to and continuesto compress first biasing member 236 until such time that pawl 154 ofratchet assembly 150 of handle assembly 100 clears and disengages rack152 thereof. With pawl 154 of ratchet assembly 150 clear and disengagedfrom rack 152, trigger 104 may be released and returned to the fullyunactuated position by hand, by a return spring 104 a of trigger 104and/or by first biasing member 236 and second biasing member 238 ofendoscopic assembly 200.

In accordance with the present disclosure, the trigger stroke length fortrigger 104 of handle assembly 100 is constant or fixed, while theclosure stroke length of the pair of jaws 250 may vary depending on theparticular endoscopic assembly 200 connected to handle assembly 100. Forexample, particular endoscopic assemblies 200 may require the pair ofjaws 250 thereof to travel a relatively greater or smaller distance inorder to complete a full opening and closing thereof. As such, varioussized and dimensioned endoscopic assemblies, including a hub assembly inaccordance with the present disclosure, substantially similar to hubassembly 210, may be connected to the universal handle assembly 100 andbe actuatable by the universal handle assembly 100.

Accordingly, various endoscopic assemblies, constructed in accordancewith the principles of the present disclosure, may be provided which arealso capable of firing or forming or closing surgical clips of varioussizes, materials, and configurations, across multiple platforms formultiple different manufactures.

Turning now to FIGS. 26-29, an endoscopic surgical clip applier, inaccordance with the present disclosure, and assembly in anotherconfiguration, is generally designated as 10′. Surgical clip applier 10′generally includes reusable handle assembly 100, at least one disposableor reusable endoscopic assembly 400 selectively connectable to andextendable distally from handle assembly 100; and optionally at leastone disposable surgical clip cartridge assembly (not shown) selectivelyloadable into a shaft assembly of a respective endoscopic assembly 400.

Turning now to FIGS. 1, 2, 16 and 17, an embodiment of an endoscopicassembly 400, of surgical clip applier 10′, is shown and described.Endoscopic assembly 400 includes a hub assembly 410, a shaft assembly420 extending from hub assembly 410, and a pair of jaws 450 pivotallyconnected to a distal end of shaft assembly 420. It is contemplated thatendoscopic assembly 400 may be configured to close, fire or formsurgical clips similar to those shown and described in U.S. Pat. No.7,819,886 or 7,905,890, the entire contents of each of which isincorporated herein by reference.

Hub assembly 410 also functions as an adapter assembly which isconfigured for selective connection to rotation knob 160 and nose 102 cof housing 102 of handle assembly 100. Hub assembly 410 includes anouter housing 412 having a cylindrical outer profile. Outer housing 412includes a first or right side half section 412 a, and a second or leftside half section 412 b. Outer housing 412 of hub assembly 410 definesan outer annular channel 412 c formed in an outer surface thereof, andat least one (or an annular array) of axially extending ribs 412 dprojecting from an outer surface thereof. Outer annular channel 412 c ofouter housing 412 of endoscopic assembly 400 is configured to receivecatch 130 d of release lever 130 of handle assembly 100 (FIGS. 28 and29) when endoscopic assembly 400 is coupled to handle assembly 100.

Ribs 412 d of outer housing 412 function as a clocking/alignment featureduring connection of endoscopic assembly 400 and handle assembly 100with one another, wherein ribs 412 d of outer housing 412 of endoscopicassembly 400 are radially and axially aligned with respective grooves160 b of rotation knob 160 (FIG. 18) of handle assembly 100. Duringconnection of endoscopic assembly 400 and handle assembly 100, ribs 412d of outer housing 412 of endoscopic assembly 400 are slidably receivedin respective grooves 160 b of rotation knob 160 of handle assembly 100.

The connection of hub assembly 410 of endoscopic assembly 400 withrotation knob 160 of handle assembly 100 enables endoscopic assembly 400to rotate 360°, about a longitudinal axis thereof, relative to handleassembly 100.

Outer housing 412 of hub assembly 410 further defines an open proximalend 412 e configured to slidably receive a distal end of drive plunger120 of handle assembly 100, when endoscopic assembly 400 is coupled tohandle assembly 100 and/or when surgical clip applier 10′ is fired.

As mentioned above, endoscopic assembly 400 includes a shaft assembly420 extending distally from hub assembly 410. Shaft assembly 420includes an elongate outer tube 422 having a proximal end 422 asupported and secured to outer housing 412 of hub assembly 410, a distalend 422 b projecting from outer housing 412 of hub assembly 410, and alumen 422 c (FIG. 27) extending longitudinally therethrough. Distal end422 b of outer tube 422 supports a pair of jaws 450.

Shaft assembly 420 further includes an inner shaft 424 slidablysupported within lumen 422 c of outer tube 422. Inner shaft 424 includesa proximal end 424 a projecting proximally from proximal end 422 a ofouter tube 422, and a distal end 424 b configured to actuate the pair ofjaws 450 to form a surgical clip (not shown) that has been loaded intothe pair of jaws 450. Proximal end 424 a, as illustrated in FIGS. 28 and29, may define a hook 424 c or other translational force couplingfeature.

With reference to FIGS. 27-29, hub assembly 410 includes a driveassembly 430 supported within outer housing 412 thereof. Drive assembly430 includes a cartridge cylinder 432 having a cup-like configuration,wherein cartridge cylinder 432 includes a longitudinally split annularwall 432 a, a proximal wall 432 b supported at and closing off aproximal end of annular wall 432 a, an open distal end 432 c, a cavityor bore 432 d defined therewithin, and a pair of axially extending slits432 e. Cartridge cylinder 432 includes an annular flange 432 f providedat distal end 432 c thereof. A ring, flange or the like 435 may befixedly supported at a proximal end of cartridge cylinder 432.

Drive assembly 430 also includes a cartridge plunger or key 434 slidablysupported within bore 432 d and within slits 432 e of cartridge cylinder432. Cartridge plunger 434 is selectively connectable to proximal end424 a of inner shaft 424. Cartridge plunger 434 is sized and configuredfor slidable receipt within slits 432 e and bore 432 d of cartridgecylinder 432 of drive assembly 430. Cartridge plunger 434 includes anelongate stem or body portion 434 a having a proximal end 434 b, and adistal end 434 c, wherein distal end 434 c of cartridge plunger 434 isconfigured for selective connection to proximal end 424 a of inner shaft424. Cartridge plunger 434 further includes a pair of opposed arms 434 dsupported at the proximal end 434 b thereof and which extend in a distaldirection along stem 434 a and towards distal end 434 c. Each arm 434 dterminates in a radially extending finger 434 e, wherein fingers 434 eproject from cartridge cylinder 432 when cartridge plunger 434 isdisposed within cartridge cylinder 432.

Drive assembly 430 may also include a collar 437 defining a lumentherethrough and through with inner shaft 424 and stem 434 a ofcartridge plunger 434 extend. Collar 437 includes an outer annularflange 437 a extending therefrom.

Drive assembly 430 includes a first biasing member 436 (e.g., acompression spring) disposed about cartridge cylinder 432. Specifically,first biasing member 436 is interposed between ring 435 supported oncartridge cylinder 432 and fingers 434 e of cartridge plunger 434. Firstbiasing member 436 has a first spring constant “K1” which is relativelymore firm or more stiff, as compared to a second spring constant “K2” ofa second biasing member 438, as is described in detail below.

Drive assembly 430 further includes a second biasing member 438 (e.g., acompression spring) supported on stem 434 a of cartridge plunger 434 andon collar 437. Specifically, second biasing member 438 is interposedbetween a flange 437 a of collar 437 and proximal end 434 b of cartridgeplunger 434. Second biasing member 438 has a second spring constant “K2”which is relatively less firm or less stiff, as compared to the firstspring constant “K1” of first biasing member 436.

Turning now to FIGS. 26-41, shaft assembly 420 of endoscopic assembly400 includes at least a spindle 440 slidably supported in lumen 422 c ofouter tube 422, a wedge plate 460 slidably supported within lumen 422 cof outer tube 422 and interposed between the pair of jaws 450 andspindle 440; a clip channel 470 fixedly supported in lumen 422 c ofouter tube 422 and disposed adjacent the pair of jaws 450 (supported inand extending from distal end 422 b of outer tube 422) on a sideopposite wedge plate 460, and a pusher bar 480 slidably supported inlumen 422 c of outer tube 422 and being disposed adjacent clip channel470.

Spindle 440 includes a proximal end 440 defining an engagement feature(e.g., a nub or enlarged head) configured to engage a complementaryengagement feature provided in distal end 424 b of inner shaft 424.Spindle 440 further includes a distal end 440 b operatively connected toa jaw cam closure wedge 442 via a slider joint 444. Jaw cam closurewedge 442 is selectively actuatable by spindle 440 to engage cammingfeatures of the pair of jaws 450 to close the pair of jaws 450 and forma surgical clip “C” loaded therewithin.

Slider joint 444 supports a latch member 446 for selective engagementwith spindle 440. Latch member 446 may be cammed in a direction towardspindle 440, wherein latch member 446 extends into a corresponding slotformed in spindle 440 during actuation or translation of spindle 440. Inoperation, during distal actuation spindle 400, at a predetermineddistance, latch member 446 is mechanically forced or cammed into andengage a channel of spindle 440. This engagement of latch member 446 inthe channel of spindle 440 allows slider joint 444 to move together withjaw cam closure wedge 442. Jaw cam closure wedge 442 thus can engage therelevant surfaces of the pair of jaws 450 to close the pair of jaws 450.

As illustrated in FIGS. 28 and 39, slider joint 444 is connected, at aproximal end 444 a thereof, to a channel formed in spindle 440. A distalend 444 b of slider joint 444 defines a substantially T-shaped profile,wherein the distal end 444 b thereof is connected to jaw cam closurewedge 442. Latch member 446 functions as a linkage and is disposed tomove through an aperture 444 c in slider joint 444 to link with anotherfixed member and prevent slider joint 444 from advancing jaw cam closurewedge 442, and thus preventing the camming of jaw cam closure wedge 442from camming the pair of jaws 450 to a closed condition during aninitial stroke of trigger 104.

Spindle 440 is provided with a camming feature configured to move a camlink 448 (pivotably connected to a filler component 466, as will bedescribed in greater detail below) a perpendicular manner relatively toa longitudinal axis of spindle 440 during a distal advancement ofspindle 440.

Clip channel 470 of shaft assembly 420 slidably retains a stack ofsurgical clips “C” therein for application, in seriatim, to the desiredtissue or vessel. A clip follower 472 is provided and slidably disposedwithin clip channel 470 at a location proximal of the stack of surgicalclips “C”. A biasing member 474 is provided to spring bias clip follower472, and in turn, the stack of surgical clips “C”, distally. A clipchannel cover 476 is provided that overlies clip channel 470 to retainand guide clip follower 472, biasing member 474 and the stack ofsurgical clips “C” in clip channel 470.

As mentioned above, shaft assembly 420 includes a pusher bar 480 forloading a distal-most surgical clip “C1” of the stack of surgical clips“C” into the pair of jaws 450. Pusher bar 480 includes a pusher 480 a ata distal end thereof for engaging a backspan of the distal-most surgicalclip “C1” and urging the distal-most surgical clip “C1” into the pair ofjaws 450. Pusher bar 480 includes a fin or tab 480 b extending therefromand extending into a slot 482 a of a trip block 482. Fin 480 b of pusherbar 480 is acted upon by a biasing member (not shown) that is supportedin trip block 482 to bias pusher bar 480 in a proximal direction.

In operation, in order for spindle 440 to advance pusher bar 480 duringa distal movement thereof, spindle 440 supports a trip lever 484 and abiasing member 486 (e.g., leaf spring). During a distal movement ofspindle 440, as illustrated in FIG. 31, a distal nose or tip 484 a oftrip lever 484 selectively engages pusher bar 480 to distally advancepusher bar 480 and load distal-most surgical clip “C1” into the pair ofjaws 450.

Also as mentioned above, shaft assembly 420 further includes a wedgeplate 460 that is biased to a proximal position by a wedge plate spring462. Wedge plate 460 is a flat bar shaped member having a number ofwindows formed therein. Wedge plate 460 has a distal-most positionwherein a tip or nose of wedge plate 460 is inserted between the pair ofjaws 450 to maintain the pair of jaws 450 in an open condition forloading of the distal-most surgical clip “C1” therein. Wedge plate 460has a proximal-most position, maintained by wedge plate spring 462,wherein the tip or nose of wedge plate 460 is retracted from between thepair of jaws 450.

As illustrated in FIGS. 28 and 38, wedge plate 460 defines a “U” or “C”shaped aperture or window 460 b in a side edge thereof. The “C” shapedaperture or window 460 b of wedge plate 460 selectively engages a camlink 448 supported on a filler plate 466. Cam link 448 selectivelyengages a surface of “C” shaped aperture or window 460 b of wedge plate460 to retain wedge plate 460 in a distal-most position such that adistal tip or nose 460 a of wedge plate 460 is maintained insertedbetween the pair of jaws 450 to maintain the pair of jaws 450 splayedapart.

Shaft assembly 420 further includes a filler component 466 interposedbetween clip channel 470 and wedge plate 460, at a location proximal ofthe pair of jaws 450. Filler component 466 pivotably supports a cam link448 that is engagable with wedge plate 460. In operation, during adistal advancement of spindle 440, a camming feature of spindle 440engages a cam link boss of cam link 448 to thereby move cam link 448 outof engagement of wedge plate 460 and permit wedge plate 460 to return tothe proximal-most position as a result of biasing member 462.

Trip block 482 defines an angled proximal surface 482 b for engagementwith a corresponding surface of trip lever 484 that will be discussedherein. As mentioned above, notch or slot 482 a of trip block 482 is forreceipt of fin 480 b of pusher bar 480. In order to disengage trip lever484 from a window 480 c (FIG. 31) of pusher bar 480, and allow pusherbar 480 to return to a proximal-most position following loading of asurgical clip “C” into the pair of jaws 450, angled proximal surface 482b trip block 482 engages trip lever 484 to cam trip lever 484 out ofwindow 480 c of pusher bar 480. It is contemplated that spindle 440 maydefine a first cavity and a second cavity therein for receiving triplever 484 and trip lever biasing spring 486, respectively. The firstcavity may be provided with a pivoting boss to allow trip lever 484 topivot between a first position and a second position. Trip lever biasingspring 486 may rest in the second cavity.

Trip lever biasing spring 486 functions to maintain a tip of trip lever484 in contact with pusher bar 480, and more specifically, within window480 c of pusher bar 480 (FIG. 31) such that distal advancement ofspindle 440 results in distal advancement of pusher bar 480, which inturn results in a loading of a distal-most surgical clip “C1” in thepair of jaws 450.

With reference to FIGS. 28, 33 and 36, clip applier 10′ also has alockout bar 490. Lockout bar 490 includes a first end, and a secondopposite hook end. The second hook end of lockout bar 490 is adapted toengage clip follower 472 of shaft assembly 420. Lockout bar 490 ispivotally retained in a slot formed in clip follower 472. Lockout bar490 does not by itself lockout clip applier 10′, but instead cooperateswith the ratchet mechanism 150 of handle assembly 100 to lock out clipapplier 10′.

Lockout bar 490 is adapted to move distally with clip follower 472 eachtime clip applier 10′ is fired, and clip follower 472 is advanceddistally. In operation, each time a surgical clip “C” is fired from clipapplier 10′, clip follower 472 will advance distally relative to theclip channel 470.

Pusher bar 480 defines a distal window therein (not shown). Inoperation, when clip follower 472 is positioned beneath pusher bar 480(e.g., when there are no remaining surgical clips), a distal end 490 aof lockout bar 490 will deflect upward (due to a biasing of a lockoutbiasing member 492), and enter a distal window 480 d of pusher bar 480to engage pusher bar 480 at a distal end of distal window 480 d.Further, a proximal end 490 b of lockout bar 490, defines a hook (FIG.37), which is rotated into and engages an aperture defined in a floor ofclip channel 470.

With the distal end of pusher bar 480 disposed within distal window 480d of pusher bar 480, pusher bar 480, and in turn, spindle 440 cannotreturn to a fully proximal position. Since spindle 440 cannot return tothe fully proximal position, pawl 152 of ratchet mechanism 150 of handleassembly 100 cannot return to the home or initial position relative torack 154 thereof. Instead, pawl 154 will remain in an intermediateposition along rack 154, thus preventing trigger 104 from returning to afully unactuated position.

With continued reference to FIGS. 26-29, an operation or firing ofsurgical clip applier 10′, including endoscopic assembly 400 operativelyconnected to handle assembly 100, is shown and described. Withendoscopic assembly 400 operatively connected to handle assembly 100, astrigger 104 of handle assembly 100 is actuated drive bar 104 b oftrigger 104 acts on drive plunger 120 to distally advance drive plunger120. As trigger 104 is actuated, pawl 154 of ratchet assembly 150 beginsto engage rack 152 thereof. With pawl 154 engaged with rack 152, trigger104 may not return to a fully unactuated position until trigger 104completes a full actuation or stroke thereof.

As drive plunger 120 is distally advanced, a distal end of drive plunger120 presses against proximal wall 432 b of cartridge cylinder 432 ofdrive assembly 430 of endoscopic assembly 400 to distally advancecartridge cylinder 432. Due to first spring constant “K1” of firstbiasing member 436 being larger or greater than second spring constant“K2” of second biasing member 438, as cartridge cylinder 432 is advanceddistally, ring 435 acts on first biasing member 436 which in turn actson fingers 434 e of cartridge plunger 434 to push cartridge plunger 434distally. As cartridge plunger 434 is distally advanced, cartridgeplunger 434 distally advances inner shaft 424 relative to outer shaft422. Being that second biasing member 438 is interposed between a flange437 a of collar 437 and proximal end 434 b of cartridge plunger 434, ascartridge plunger 434 is distally advanced, cartridge plunger 434 alsocompresses second biasing member 438.

As inner shaft 424 is distally advanced relative to outer shaft 422,inner shaft 424 actuates a clip pusher (not shown) which in turn acts ona distal-most surgical clip (not shown) of a stack of surgical clips(not shown) to distally advance the distal-most surgical clip into thepair of jaws 450. Following loading of the distal-most surgical clipinto the pair of jaws 450, the distal advancement of inner shaft 424effects a closure of the pair of jaws 450 to form the surgical cliploaded therewithin.

When the pair of jaws 450 have fully closed to form the surgical cliploaded therein, or when the pair of jaws 450 have reached a hard stop,pawl 154 of ratchet assembly 150 of handle assembly 100 may not havecleared rack 152 thereof, and thus blocks or prevents trigger 104 fromreturning to a fully unactuated position thereof. Since the pair of jaws450 cannot close any further, inner shaft 422 is also stopped fromfurther distal advancement. However, as mentioned above, in order toreturn trigger 104 to the fully unactuated position, trigger 104 mustfirst complete the full actuation stroke thereof. As such, as trigger104 is further actuated to complete the full stroke thereof, as driveplunger 120 is continued to be driven distally, the distal end of driveplunger 120 continues to press against proximal wall 432 b of cartridgecylinder 432 of drive assembly 430 of endoscopic assembly 400 tocontinue to distally advance cartridge cylinder 432.

With inner shaft 422, and in turn cartridge plunger 434, stopped fromany further distal advancement, as cartridge cylinder 432 is continuedto be advanced distally relative to cartridge plunger 434, cartridgecylinder 432 begins to and continues to compress first biasing member436 until such time that pawl 154 of ratchet assembly 150 of handleassembly 100 clears and disengages rack 152 thereof. With pawl 154 ofratchet assembly 150 clear and disengaged from rack 152, trigger 104 maybe released and returned to the fully unactuated position by hand, by areturn spring (not shown) of trigger 104 or handle assembly 100 and/orby first biasing member 436 and second biasing member 438 of endoscopicassembly 400.

With reference to FIGS. 42-53B, another embodiment of an endoscopicassembly is provided and generally identified by reference numeral 500.The endoscopic assembly 500 is similar to the endoscopic assembly 400,and therefore, for purposes of brevity, only the differencestherebetween are described in detail hereinbelow.

The hub assembly 510 of the endoscopic assembly 500 includes an outerhousing 512 having a generally cylindrical outer profile and includes afirst or right side half section 512 a and a second or left side halfsection 512 b. An outer surface of the outer housing 512 of the hubassembly 510 defines an outer annular channel 512 c therein to receivethe catch 130 d of the release lever 130 of the handle assembly 100(FIGS. 28 and 29) when the endoscopic assembly 500 is coupled to thehandle assembly 100.

An inner surface 514 (FIG. 45) of the outer housing 512 of the hubassembly 510 defines a channel 516 therethrough extending throughproximal and distal end surfaces thereof. A proximal portion 516 a ofthe channel 516 is configured to slidably receive a portion of acartridge cylinder 520 therein. A medial portion 516 b of the channel516 is disposed adjacent and distal to the proximal portion 516 a. Thegreater width of the medial portion 516 b defines a distal facingsurface 516 c at an intersection of the proximal portion 516 a and themedial portion 516 b. A distal portion of the medial portion 516 bdefines an annular flange 516 d extending radially inward and having aproximal facing surface 516 e and an opposite, distal facing surface 516f. The annular flange 516 d defines a generally rectangular profileconfigured to slidably receive a driver gear 560 and inhibit rotation ofthe driver gear 560 therewithin.

The inner surface 514 of the outer housing 512 defines a chamber 516 gthat is disposed adjacent and distal to the annular flange 516 d. Thechamber 516 g defines a width that is greater than the annular flange516 d and the medial portion 516 b, although it is contemplated that thewidth of the chamber 516 g may be equal to or less than the width of themedial portion 516 b. The inner surface 514 of the outer housing 512defines a pair of opposed bosses 518 adjacent to, and extending from,the annular flange 516 d. Each boss of the pair of opposed bosses 518defines a generally rectangular profile extending in a distal directionfrom the annular flange 516 d and defining an upper portion 518 a and alower portion 518 b. The lower portion 518 b extends further in a distaldirection than the upper portion 518 a and upper portion 518 a extendsradially inward a greater amount than the lower portion 518 b such thateach of the upper portion 518 a and the lower portion 518 b selectivelyengage different components of the hub assembly 510. A distal portion ofthe upper portion 518 a defines a first bevel 518 c that is angled in adistal to proximal direction (e.g., the distal most portion is closestto a medial portion of the chamber 516 g). A distal portion of the lowerportion 518 b defines a second bevel 518 d that is oriented in anopposite direction than that of the first bevel, such that the first andsecond bevels 518 c and 518 d are oriented in a mirrored fashion about alongitudinal axis X-X (FIG. 45) defined through the channel 516.

The inner surface 514 of the outer housing 512 defines a plurality ofwindows 516 h therethrough at a distal portion of the chamber 516 g. Aswill be described in further detail hereinbelow, the plurality ofwindows 516 h enable a contrasting color 558 (FIG. 48) disposed on thedisplay gear 550 to be visible therethrough when a final surgical clipof a plurality of surgical clips has been formed. A distal end wall 516i of the chamber 516 g defines a counter bore 516 j configured toreceive an over-stroke sleeve 610 (FIG. 44) of an over-stroke mechanism600. An inner surface of the counterbore 516 j defines a plurality oflongitudinally extending slots 516 k configured to engage acorresponding plurality of longitudinally extending splines defined onan outer surface of the over-stroke sleeve 610. A distal most portion516L of the channel 516 is configured to slidably receive a portion ofthe outer shaft 422 of the endoscopic assembly 400 therethrough.

The cartridge cylinder 520 includes an elongate body 520 a defining aproximal end wall 520 b and a distal end wall 520 c (FIG. 46). Theproximal end wall 520 b is configured to engage the drive plunger 120 ofthe handle assembly 100, such that distal advancement of the driveplunger 120 causes a corresponding distal advancement of the cartridgecylinder 520 within the proximal portion 516 a of the channel 516. Theelongate body 520 a defines a radially extending flange 522 adjacent tothe distal end wall 520 c and defines a proximally facing surface 522 a.As illustrated in FIG. 46, the proximally facing surface 522 a isconfigured to abut the distal facing surface 516 c of the medial portion516 b when the cartridge cylinder 520 is in an initial, proximalposition and inhibit further proximal translation thereof. The distalend wall 520 c of the cartridge cylinder 520 defines a longitudinallyextending boss 524 that extends in a distal direction therefrom. Thelongitudinally extending boss 524 defines a channel 526 through a distalend portion thereof configured to slidably receive a linkage 530. Adistal end portion of the longitudinally extending boss 524 defines alateral bore 524 a extending normal to the channel 526. Lateral bore 524a is configured to receive a proximal linkage pin 532 to rotatablysecure the linkage 530 thereto, such that distal advancement of thecartridge cylinder 520 effectuates a corresponding distal advancement ofthe linkage 530.

The linkage 530 (FIG. 44) defines a generally rectangular profileextending between proximal and distal end portions 530 a and 530 b,respectively, although it is contemplated that the linkage may defineother suitable profiles such as elliptical, etc. The linkage 530 definesproximal and distal apertures 530 c and 530 d therethrough atcorresponding proximal and distal end portions 530 a, 530 b thereof. Theproximal aperture 530 c is configured to receive the proximal linkagepin 532 therein to rotatably secure the linkage 530 to the cartridgecylinder 520 (e.g., the proximal linkage pin 532 is received within theproximal aperture 530 c of the linkage 530 and the lateral bore 524 a ofthe cartridge cylinder 520). The distal aperture 530 d is configured toreceive a distal linkage pin 534 that is configured to couple thespindle 540 to the linkage 530.

With reference to FIG. 47, the spindle 540 defines a generallycylindrical profile extending between proximal and distal end portions540 a and 540 b, respectively, although it is contemplated that thespindle 540 may define other suitable profiles, such as elliptical,rectangular, square, etc. An outer surface 540 c of the spindle 540defines a pair of opposed flats 542 thereon, and defines a slot 544therethrough at the proximal end portion 540 a of the spindle 540. Theslot 544 extends through a proximal end surface 540 d defined on theproximal end portion 540 a such that the linkage 530 may be slidablyreceived therein. The outer surface 540 c of the spindle 540 defines atransverse hole 546 therethrough that is oriented normal to the slot 544such that when the linkage 530 is received within the slot 544, thetransverse hole 546 and the distal aperture 530 d of the linkage 530 arecoaxially aligned. The distal linkage pin 534 is configured to bereceived within the transverse hole 546 to rotatably secure the linkage530 to the spindle 540 such that distal advancement of the linkage 530causes a corresponding distal advancement of the spindle 540 andproximal retraction of the linkage 530 causes a corresponding proximalretraction of the spindle 540. The pair of opposed flats 542 define achannel 548 through a medial portion thereof that is configured toslidably receive an over-stroke pin 630 (FIG. 44) of the over-strokemechanism 600 therein. Although generally illustrated as being disposedat a medial portion of the spindle 540, it is contemplated that thechannel 548 may be disposed at any location along the length of thespindle 540. The outer surface 540 c of the spindle defines a transverseslot 540 e therethrough configured to selectively receive a portion ofthe lockout spring 592 therein. The transverse slot 540 e is orientednormal to the channel 548 and is longitudinally disposed such that thetransverse slot 540 e extends entirely therethrough. As can beappreciated, the transverse slot 540 e may be a single slot or mayinclude a pair of opposed slots that do not extend within the channel548. The transverse slot 540 e is disposed at a location configured topermit the lockout spring 592 (FIG. 44) to be received therein once thefinal surgical clip of the plurality of surgical clips has been formed,as will be described in further detail hereinbelow.

Turning now to FIGS. 48 and 49, the hub assembly 510 of the endoscopicassembly 500 includes a display gear 550 rotatably and slidably disposedwithin the chamber 516 g of the channel 516. The display gear 550defines a generally cylindrical profile extending between proximal anddistal end surfaces 550 a and 550 b, respectively. The proximal anddistal end surfaces 550 a and 550 b of the display gear 550 define anaperture 552 therethrough that is configured to slidably receive thespindle 540 therein. The proximal end surface 550 a of the display gear550 defines an annular relief 554 thereon and terminating at a proximalfacing surface 554 a. The proximal facing surface 554 a of the displaygear 550 defines a plurality of teeth 556 thereon. The plurality ofteeth 556 is arranged in a circumferential direction about the proximalfacing surface 554 a. The plurality of teeth 556 defines a firstplurality of teeth 556 a having a first thickness and a second pluralityof teeth 556 b having a second thickness. In this manner, the secondplurality of teeth 556 b extends radially inward a greater amount thanthe first plurality of teeth 556 a. In embodiments, the first pluralityof teeth 556 a includes twelve teeth, although it is contemplated thatany suitable number of teeth may be utilized depending upon the needs ofthe procedure being performed. Although generally illustrated asincluding a pair of teeth defined on the proximal facing surface 554 aat diametrically opposed locations, it is contemplated that the secondplurality of teeth 556 b may include any suitable number of teeth andeach tooth may be disposed at any suitable location relative to oneanother. In operation, the first plurality of teeth 556 a is configuredto selectively engage the lower portion 518 b of the pair of opposedbosses 518 of the inner surface 514 of the outer housing 512 and thesecond plurality of teeth 556 b is configured to selectively engage thepair of opposed teeth 568 b of the transmission gear 560.

The proximal facing surface 554 a of the annular relief 554 defines anannular slot 554 b (FIG. 48a ) extending towards the distal end surface550 b. The annular slot 554 b of the annular relief 554 is configured toselectively receive a portion of the transmission gear 560, as will bedescribed in further detail hereinbelow. A proximal portion of aninterior surface 552 a of the aperture 552 defines an annular groove 552b (FIG. 48a ) therein configured to receive and retain the lockoutspring 592 therein. The distal end surface 550 b of the display gear 550defines a counterbore 552 c therein that is defined concentric with theaperture 552 and terminates at a distal facing surface 552 d. Thecounterbore 552 c is configured to abut a display gear biasing element580. In embodiments, the distal end surface 550 b of the display gear550 may define a planar configuration configured to abut the displaygear biasing element 580.

An outer surface 550 c of the display gear 550 defines a plurality ofsections having a contrasting color 558. The contrasting color 558 maybe any suitable color capable of indicating to the clinician that thenumber of surgical clips remaining in the clip cartridge assembly (notshown) is below a certain threshold and that the last remaining surgicalclip within the clip cartridge assembly has been formed. In this manner,as the display gear 550 is rotated, the amount of the contrasting color558 that is visible through the plurality of windows 516 h of the outerhousing 512 increases until the entirety of each window of the pluralityof windows 516 h displays the contrasting color 558 to indicate thatthere are no surgical clips remaining in the clip cartridge assembly.

With reference to FIGS. 50 and 51, the hub assembly 510 of theendoscopic assembly 500 includes a transmission gear 560 rotatably andslidably disposed within the chamber 516 g of the channel 516. Thetransmission gear 560 defines a generally cylindrical profile extendingbetween proximal and distal end surfaces 560 a and 560 b, respectively.The proximal and distal end surfaces 560 a, 560 b define a throughbore562 therethrough that is configured to slidably receive the spindle 540therein. The proximal end surface 560 a defines a counterbore 564therethrough terminating at a medial portion of the transmission gear560, although it is contemplated that the counterbore 564 may terminateat any suitable depth. The proximal end surface 560 a defines aplurality of teeth 566 thereon configured to selectively engage aportion of teeth defined on the driver gear 570 and a portion of theupper portion 518 a of the pair of opposed bosses 518 of the innersurface of the outer housing 512, as will be described in further detailhereinbelow. Each tooth of the plurality of teeth 566 defines agenerally horizontal portion 566 a and a generally beveled portion 566 bsuch that as the generally beveled portion 566 b of the transmissiongear 560 engages the first bevel 518 c of the upper portion 518 a of thepair of opposed bosses 518, the transmission gear 560 is caused torotate.

The distal end surface 560 b defines an annular relief 568 terminatingat a distal facing surface 568 a. Although generally illustrated asterminating at a medial portion of the transmission gear 560, it iscontemplated that the annular relief 568 may terminate at any suitableportion of the transmission gear 560. The annular relief 568 defines anouter surface 568 a including a pair of opposed teeth 568 b disposedthereon. Each tooth of the pair of opposed teeth 568 b defines a beveledsurface 568 c configured to abut a corresponding tooth of the secondplurality of teeth 556 b of the display gear 550. The annular relief 568of the transmission gear 560 is configured to be received within aportion of the annular relief 554 of the display gear 550 to provideadditional support and help maintain concentricity between thetransmission gear 560 and the display gear 550.

With reference to FIGS. 51 and 52, the hub assembly 510 of theendoscopic assembly 500 includes a driver gear 570 slidably disposedwithin the chamber 516 g of the channel 516. The driver gear 570 definesan elongate body extending between proximal and distal end portions 572a and 572 b, respectively. The elongate body of the driver gear 570defines a generally square profile when viewed in a proximal to distalorientation and is configured to be slidably received within the annularflange 516 d of the channel 516 such that the driver gear 570 isinhibited from rotating with respect to the annular flange 516 d. Thedistal end portion 572 b defines a radially extending flange 574 havinga generally cylindrical profile. A distal face 574 a of the radiallyextending flange 574 defines a plurality of teeth 576 extending distallytherefrom. Although generally illustrated as having four teeth, it iscontemplated that the plurality of teeth 576 may include any suitablenumber of teeth, such as two, three, five, six, etc. Each tooth of theplurality of teeth 576 defines a generally horizontal upper surface 576a and a generally beveled surface 576 b disposed opposite thereto. Ascan be appreciated, the orientation of the horizontal upper surface 576a and the beveled surface 576 b of the plurality of teeth 576 areopposite (e.g., mirrored) to that of the beveled portion 566 b and thehorizontal portion 566 a of the plurality of teeth 566 of thetransmission gear 560. As will be described in further detailhereinbelow, the pair of opposed bosses 518 of the inner surface 514 ofthe outer housing 512, the first and second plurality of teeth 556 a,556 b of the display gear 550, the plurality of teeth 566 and the pairof opposed teeth 568 b of the transmission gear 560, and the pluralityof teeth 576 of the driver gear 570 cooperate to rotate the display gear550 each time a surgical clip is formed.

An outer surface 570 a of the driver gear 570 defines a longitudinalslot 570 b therein configured to slidably receive the distal linkage pin534 therein. As can be appreciated, engagement of the distal linkage pin534 within the longitudinal slot 570 b maintains the orientation of thespindle 540 relative to the driver gear 570 during longitudinal movementof the spindle 540. Additionally, during proximal retraction of thespindle 540, the distal linkage pin 534 abuts a proximal portion of thelongitudinal slot 570 b to urge the driver gear 570 in a proximaldirection. The proximal end portion 572 a and the distal face 574 a ofthe radially extending flange 574 define a throughbore 578 therethroughthat is configured to slidably receive the spindle 540 therethrough.

With reference to FIGS. 43 and 44, a display gear biasing element 580 isinterposed between the distal end wall 516 m of the channel 516 and thedistal end surface 550 b of the display gear 550. The display gearbiasing element 580 biases the display gear 560 in a proximal directionsuch that the first plurality of teeth 556 of the display gear 550engage the second bevel 518 d of the lower portion 518 b of the pair ofopposed bosses 518 (FIG. 45). Although generally illustrated as being acoil spring, it is contemplated that the display gear biasing element580 may be any suitable biasing element such as a compression spring, anextension spring, a leaf spring, a Bellville washer or plurality ofBellville washers, an elastomer spring, a gas spring, etc.

A return biasing element 590 is disposed within the medial portion 516 bof the channel 516 and is interposed between the distal end wall 520 cof the cartridge cylinder 520 and the annular flange 516 d of thechannel 516. Although generally illustrated as being a coil spring, itis contemplated that the return biasing element 590 may be any suitablebiasing element capable of biasing the cartridge cylinder 520 in aproximal direction, such as a compression spring, and extension spring,a leaf spring, a Bellville washer or plurality of Bellville washers, anelastomer spring, a gas spring, etc.

With reference to FIGS. 53A and 53B, the lockout spring 592 defines agenerally lemniscate configuration, although other suitableconfigurations are also contemplated. The radially inward extendingportions of the lockout spring 592 terminate at an interior portionthereof, such that each side of the lockout spring 592 remains in aspaced apart configuration forming a gap 592 a therebetween configuredto slidably receive the spindle 540 therein. A medial portion of thelockout spring 592 defines a pair of opposed tabs 592 a defining agenerally planar configuration, although other suitable configurationsare also contemplated. The lemniscate profile of the lockout spring 592biases the pair of opposed tabs 592 toward one another, thereby reducingthe gap 592 b formed therebetween. An upper and lower portion of thelockout spring 592 is configured to be received within the annulargroove 552 b of the display gear 550 such that the lockout spring 592 isretained therein and inhibited from rotating relative to the displaygear 550.

In operation, the spindle 540 is disposed within the gap 592 b definedbetween the pair of opposed tabs 592 and is permitted to reciprocatetherein during the formation of each surgical clip. Once a finalsurgical clip has been formed, the spindle 540 is permitted to advancein a distal direction until the pair of opposed tabs 592 a of thelockout spring 592 align with the transverse slot 540 e of the spindle.The bias of the lockout spring 592 urges the pair of opposed tabs 592 ain a medial direction such that each tab of the pair of opposed tabs 592is received within the transverse slot 540 e to inhibit furthertranslation of the spindle 640 in a distal or proximal direction.

With reference to FIGS. 43 and 54-62, in operation and in an initialstate, the return biasing element 590 biases the cartridge cylinder 520in a proximal direction to an initial, retracted position. In thisinitial position, the distal linkage pin 534 abuts a proximal portion ofthe longitudinal slot 570 b of the driver gear 570 and causes the drivergear to be placed in an initial, proximal position. Additionally, thedisplay gear biasing element 580 biases the display gear 550 in aninitial, proximal position such that the first plurality of teeth 556 aof the display gear 550 engage the lower portion 518 b of the pair ofopposed bosses 518 of the inner surface 514 of the outer housing 512.

As the clinician actuates the trigger 104 of the handle assembly 100,the drive plunger 120 is driven in a distal direction and abuts theproximal end wall 520 b of the cartridge cylinder 520. Continuedactuation of the trigger 104 causes the drive plunger 120, and therebythe cartridge cylinder 520, to further advance in a distal direction andcompress the return biasing element 590. Distal advancement of thecartridge cylinder 520 causes a corresponding distal advancement of thelinkage 530 and spindle 540. During initial advancement of the spindle540, the distal linkage pin 534 translates within the longitudinal slot570 b of the driver gear 570 to allow distal advancement of the spindle540 without causing a corresponding distal advancement of the drivergear 570. As the trigger 104 is further actuated, the distal linkage pin534 abuts a distal portion of the longitudinal slot 570 b and causes thedriver gear 570 to also advance in a distal direction. Continuedactuation of the trigger 104 causes further distal advancement of thespindle 540 and a corresponding distal advancement of the driver gear570 until the driver gear 570 engages the transmission gear 560. Duringengagement of the driver gear 570 with the transmission gear 560, thegenerally beveled portions 566 b of the plurality of teeth 566 of thetransmission gear 560 abut the generally beveled surfaces 576 b of theplurality of teeth 576 of the driver gear 570 thereby causing thetransmission gear to rotate 1/24^(th) of a rotation (e.g., 15 degrees).Although generally illustrated as rotating in a counterclockwisedirection, it is contemplated that the transmission gear may also becaused to rotate in a clockwise direction.

Additional actuation of the trigger 104 causes further distaltranslation of the transmission gear 560 and engagement of thetransmission gear 560 with the display gear 550. Due to theconfiguration of the first and second plurality of teeth 556 a, 556 b ofthe display gear 550, the display gear 550 is caused to rotate onlyevery 6 actuations of the trigger 104. As such, the display gear 550 andthe transmission gear 560 are oriented such that the first and secondplurality of teeth 556 a, 556 b of the display gear are misaligned withthe pair of opposed teeth 568 b of the transmission gear, therebyresulting in no rotation of the display gear 550, and a second scenariowherein the display gear 550 and the transmission gear 560 are orientedsuch that the first and second plurality of teeth 556 a, 556 b of thedisplay gear are aligned with the pair of opposed teeth 568 b of thetransmission gear such that the display gear 550 is caused to rotate.

More specifically, in the first scenario, the pair of opposed teeth 568b of the transmission gear 560 are misaligned with the second pluralityof teeth 556 b of the display gear 550. In this instance, the pair ofopposed teeth 568 b of the transmission gear 560 abut the proximalfacing surface 554 a of the display gear and drive the display gear 550in a distal direction and compressing the display gear biasing element580. At this point, the spindle 540 continues to be urged in a distaldirection and form a surgical clip that is loaded between the pair ofjaws 450 of the endoscopic assembly 400.

Once the surgical clip has been formed and the clinician releases thetrigger 104 of the handle housing 100, the return biasing element 590biases the cartridge cylinder 520 in a proximal direction, therebyurging the linkage 530 and spindle 540 in a proximal direction. Thedisplay gear biasing element 580 biases the display gear 550 in aproximal direction and causes the transmission gear 560 and driver gear570 to also translate in a proximal direction. The display gear biasingelement 580 continues to urge the display gear 550 in a proximaldirection causing the proximal facing surface 554 a of the display gear550 to abut the lower portion 518 b of the pair of opposed bosses 518 ofthe inner surface 514 of the outer housing 512. In this instance,because the display gear 550 has not rotated relative to the lowerportion 518 b of the pair of opposed bosses 518, the first plurality ofteeth 556 a engage the lower portion 517 b of the pair of opposed bosses518 at a similar location from where they were initially, resulting inno rotation of the display gear 550.

As the transmission gear 580 disengages from the display gear 550 andthe transmission gear 560 is further urged in a proximal direction, thegenerally beveled portions 566 b of the plurality of teeth 566 of thetransmission gear 560 abut the first bevel 518 c of the upper portion518 a of the pair of opposed bosses 518 and cause the transmission gear560 to rotate a further 1/24^(th) of a rotation (e.g., 15 degrees),resulting in a total rotation of 1/12^(th) of a rotation (e.g., 30degrees). As can be appreciated, the amount of rotation of thetransmission gear 560 is correlated to the number of surgical clips tobe fired, and therefore, the amount of rotation during each firing of asurgical clip may vary accordingly.

In the second scenario, the pair of opposed teeth 568 b of thetransmission gear 560 are aligned with the second plurality of teeth 556b of the display gear 550. In this instance, the beveled surface 568 cof each tooth of the pair of opposed teeth 568 b abuts a respectivetooth of the second plurality of teeth 556 b to cause the display gear550 to rotate. Although generally shown as rotating in a clockwisedirection, it is contemplated that the display gear 550 may also rotatein a counterclockwise direction. Continued actuation of the trigger 104further urges the transmission gear 560 in a distal direction, causingthe display gear 550 to rotate 1/24^(th) of a rotation (e.g., 15degrees) and urge the display gear 550 in a distal direction andcompressing the display gear biasing element 580. At this point, thespindle 540 continues to be urged in a distal direction to form asurgical clip that is loaded between the pair of jaws 450 of theendoscopic assembly 400.

Once the surgical clip has been formed and the clinician releases thetrigger 104 of the handle housing 100, the return biasing element 590biases the cartridge cylinder 520 in a proximal direction, therebyurging the linkage 530, and the spindle 540, in a proximal direction.The display gear biasing element 580 biases the display gear 550 in aproximal direction and causes the transmission gear 560 and the drivergear 570 to also translate in a proximal direction. The display gearbiasing element 580 continues to urge the display gear 550 in a proximaldirection causing the first plurality of teeth 556 a of the display gear550 to abut the beveled surface 518 d of the lower portion 518 b of thepair of opposed bosses 518, which causes the display gear 550 to rotatea further 1/24^(th) of a rotation (e.g., 15 degrees), resulting in atotal rotation of 1/12^(th) of a rotation (e.g., 30 degrees). As can beappreciated, the amount of rotation of the display gear 550 iscorrelated to the number of surgical clips to be fired, and therefore,the amount of rotation per engagement with the lower portion 518 of thepair of opposed bosses 518 may vary accordingly. As describedhereinabove, the display gear 550 is configured to rotate twice for agiven stack of surgical clips (e.g., once every 6 clips). Thus, afterthe initial 1/12^(th) of a rotation (e.g., 30 degrees), a portion of thecontrasting color 558 of the display gear 550 is visible through theplurality of windows 516 h of the outer housing 512 (FIG. 61A). Afterthe second 1/12^(th) of a rotation (e.g., 30 degrees) of the displaygear 550, the entirety of the each window of the plurality of windows516 h is filled by the contrasting color 558 of the display gear 550 toindicate that all of the surgical clip with the clip cartridge assemblyhave been formed (FIG. 61B).

After the second 1/12^(th) of a rotation of the display gear 550, thepair of opposed tabs 592 a of the lockout spring 592 align with thetransverse slot 540 e of the spindle 540, permitting the pair of opposedtabs 592 a to be received within the transverse slot 540 e (FIG. 52).Once received within the transverse slot 540 e, the pair of opposed tabs592 a inhibit proximal and distal translation of the spindle 540 (e.g.,locking the spindle 540 in place) such that if the clinician actuatesthe trigger 104 of the handle assembly 100 again, the clinician isunable to actuate the trigger 104 and close the pair of jaws 450 of theendoscopic assembly 400 to prevent injury to the patient and medicalpersonnel and prevent damage to the surgical clip applier 10′.

With reference to FIGS. 43, 44, and 62, it is contemplated that theendoscopic assembly 400 may include an over-stroke mechanism 600disposed within the counterbore 516 j of the channel 516 of the outerhousing 512. The over-stroke mechanism 600 includes an over-strokesleeve 610, an over-stroke biasing element 620, and an over-stroke pin630. The over-stroke sleeve 610 defines a generally cylindricalconfiguration extending between proximal and distal end surfaces 610 aand 610 b, respectively. The proximal and distal end surfaces 610 a, 610b define an aperture 612 therethrough configured to slidably receive theouter shaft 422 of the endoscopic assembly 400 therein. The proximal endsurface 610 a defines a counterbore 614 (FIG. 64B) therethroughterminating at a proximal facing surface 614 a (FIG. 64B). Thecounterbore 614 is configured to receive the over-stroke biasing element620 therein. Although generally illustrated as being a coil spring, itis contemplated that the over-stroke biasing element 620 may be anysuitable biasing element such as a Bellville washer, a plurality ofBellville washers, an elastomeric spring, a gas spring, a leaf spring,etc.

An outer surface 610 c of the over-stroke sleeve 610 defines alongitudinal slot 616 therethrough adjacent the proximal end surface 610a. Longitudinal slot 616 is configured to slidably receive theover-stroke pin 630 therein and act as a travel limiter for the spindle540. As illustrated in FIG. 64B, the over-stroke biasing element 620 isinterposed between the proximal facing surface 614 a of the over-strokesleeve 610 and the over-stroke pin 630. The outer surface 610 c of theover-stroke sleeve 610 defines a generally crenellated profile having aplurality of longitudinally extending splines 618 configured to engagethe plurality of longitudinally extending slots 516 k of the counterbore516 j of the channel 516, such that the over-stroke sleeve 610 isinhibited from rotating relative to the outer housing 512.

For a detailed description of exemplary over-stroke mechanisms for usewith endoscopic surgical clip appliers such as those described herein,reference can be made to U.S. Provisional Patent Application Ser. No.62/527,222 to Baril, filed Jun. 30, 2017 and titled “ENDOSCOPICREPOSABLE SURGICAL CLIP APPLIER,” the entire content of which isincorporated by reference herein.

With reference to FIGS. 64A-64E, the operation of the over-strokemechanism 600 will be described where the spindle 540 has translated ina distal direction further than is normal during the forming a surgicalclip. In the initial, unactuated position, the over-stroke pin 630 isdisposed within an aperture defined within a proximal portion of theouter shaft 422, within the channel 548 of the spindle 540, and withinthe longitudinal slot 616 of the over-stroke sleeve 610. Duringactuation of the trigger 104 of the handle assembly 100, the spindle 540is urged in a distal direction such that the over-stroke pin 630transitions from a distal position within the channel 548 of the spindle540 to a proximal position within the channel 548. If the trigger 104 isfurther actuated, the spindle 540 is further urged in a distal directionwhich can cause damage to the pair of jaws 450 of the endoscopicassembly 400. To prevent damage to the pair of jaws 450, as the spindle540 translates further in a distal direction, the over-stroke pin 630,and therefore the outer shaft 422, is urged in a distal direction alongwith the spindle 540, thereby causing the over-stroke biasing element620 to compress. The compression of the over-stroke biasing element 620,and resulting distal translation of the outer shaft 422, eliminatesfurther clamping of the pair of jaws 450 and prevents any damage to thepair of jaws 450. Upon release of the trigger 104 of the handle assembly100, the over-stroke biasing element 620 urges the over-stroke pin 630in a proximal direction and returns the outer shaft 422 to its initial,proximal position. The longitudinal slot 616 of the over-stroke sleeve610 inhibits the over-stroke pin 620 from translating in a proximaldirection past the initial, proximal position of the outer shaft 422.

It is further contemplated that the over-stroke mechanism 600 mayprevent damage to the pair of jaws 450 if the pair of jaws 450 becomejammed or an object otherwise becomes lodged between the pair of jaws450. In this manner, as the spindle 540 is coupled to the outer shaft422, distal translation of the spindle 540 causes the outer shaft 422 toconcurrently translate in a distal direction if the pair of jaws 450 areunable to close. For a detailed description of the operation of theover-stroke mechanism 600, reference can be made to U.S. ProvisionalPatent Application Ser. No. 62/527,222 to Baril, previously incorporatedby reference herein.

In accordance with the present disclosure, the trigger stroke length fortrigger 104 of handle assembly 100 is constant or fixed, while theclosure stroke length of the pair of jaws 450 of endoscopic assembly 400connected to handle assembly 100 is different than, for example, theclosure stroke of the pair of jaws 250 of endoscopic assembly 200. Forexample, endoscopic assembly 400 may require the pair of jaws 450thereof to travel a relatively greater or smaller distance as comparedto the pair of jaws 250 of endoscopic assembly 200 in order to completea full opening and closing thereof. As such, universal handle assembly100 may be loaded with, and is capable of firing, either endoscopicassembly 200 or endoscopic assembly 400.

In accordance with the present disclosure, while the trigger strokelength of trigger 104 of handle assembly 100 is constant, the closurestroke length for the pair of jaws 250, 450 of each endoscopic assembly200, 400 is unique for each respective endoscopic assembly 200, 400.Accordingly, each drive assembly 230, 430 of respective endoscopicassemblies 200, 400 functions to accommodate for the variations in theclosure stroke lengths for the pair of jaws 250, 450 of respectiveendoscopic assemblies 200, 400.

To the extent consistent, handle assembly 100 and/or endoscopicassemblies 200, 400 may include any or all of the features of the handleassembly and/or endoscopic assemblies disclosed and described inInternational Patent Application No. PCT/CN2015/080845, filed Jun. 5,2015, entitled “Endoscopic Reposable Surgical Clip Applier,”International Patent Application No. PCT/CN2015/091603, filed on Oct.10, 2015, entitled “Endoscopic Surgical Clip Applier,” and/orInternational Patent Application No. PCT/CN2015/093626, filed on Nov. 3,2015, entitled “Endoscopic Surgical Clip Applier,” the entire content ofeach of which being incorporated herein by reference.

Surgical instruments such as the clip appliers described herein may alsobe configured to work with robotic surgical systems and what is commonlyreferred to as “Telesurgery.” Such systems employ various roboticelements to assist the surgeon and allow remote operation (or partialremote operation) of surgical instrumentation. Various robotic arms,gears, cams, pulleys, electric and mechanical motors, etc. may beemployed for this purpose and may be designed with a robotic surgicalsystem to assist the surgeon during the course of an operation ortreatment. Such robotic systems may include remotely steerable systems,automatically flexible surgical systems, remotely flexible surgicalsystems, remotely articulating surgical systems, wireless surgicalsystems, modular or selectively configurable remotely operated surgicalsystems, etc.

The robotic surgical systems may be employed with one or more consolesthat are next to the operating theater or located in a remote location.In this instance, one team of surgeons or nurses may prep the patientfor surgery and configure the robotic surgical system with one or moreof the instruments disclosed herein while another surgeon (or group ofsurgeons) remotely control the instruments via the robotic surgicalsystem. As can be appreciated, a highly skilled surgeon may performmultiple operations in multiple locations without leaving his/her remoteconsole which can be both economically advantageous and a benefit to thepatient or a series of patients.

The robotic arms of the surgical system are typically coupled to a pairof master handles by a controller. The handles can be moved by thesurgeon to produce a corresponding movement of the working ends of anytype of surgical instrument (e.g., end effectors, graspers, knifes,scissors, etc.) which may complement the use of one or more of theembodiments described herein. The movement of the master handles may bescaled so that the working ends have a corresponding movement that isdifferent, smaller or larger, than the movement performed by theoperating hands of the surgeon. The scale factor or gearing ratio may beadjustable so that the operator can control the resolution of theworking ends of the surgical instrument(s).

The master handles may include various sensors to provide feedback tothe surgeon relating to various tissue parameters or conditions, e.g.,tissue resistance due to manipulation, cutting or otherwise treating,pressure by the instrument onto the tissue, tissue temperature, tissueimpedance, etc. As can be appreciated, such sensors provide the surgeonwith enhanced tactile feedback simulating actual operating conditions.The master handles may also include a variety of different actuators fordelicate tissue manipulation or treatment further enhancing thesurgeon's ability to mimic actual operating conditions.

Referring to FIG. 65, a medical work station is shown generally as workstation 1000 and generally may include a plurality of robot arms 1002,1003; a control device 1004; and an operating console 1005 coupled withcontrol device 1004. Operating console 1005 may include a display device1006, which may be set up in particular to display three-dimensionalimages; and manual input devices 1007, 1008, by means of which a person(not shown), for example a surgeon, may be able to telemanipulate robotarms 1002, 1003 in a first operating mode.

Each of the robot arms 1002, 1003 may include a plurality of members,which are connected through joints, and an attaching device 1009, 1011,to which may be attached, for example, a surgical tool “ST” supportingan end effector 1100, in accordance with any one of several embodimentsdisclosed herein, as will be described in greater detail below.

Robot arms 1002, 1003 may be driven by electric drives (not shown) thatare connected to control device 1004. Control device 1004 (e.g., acomputer) may be set up to activate the drives, in particular by meansof a computer program, in such a way that robot arms 1002, 1003, theirattaching devices 1009, 1011 and thus the surgical tool (including endeffector 1100) execute a desired movement according to a movementdefined by means of manual input devices 1007, 1008. Control device 1004may also be set up in such a way that it regulates the movement of robotarms 1002, 1003 and/or of the drives.

Medical work station 1000 may be configured for use on a patient 1013lying on a patient table 1012 to be treated in a minimally invasivemanner by means of end effector 1100. Medical work station 1000 may alsoinclude more than two robot arms 1002, 1003, the additional robot armslikewise being connected to control device 1004 and beingtelemanipulatable by means of operating console 1005. A medicalinstrument or surgical tool (including an end effector 1100) may also beattached to the additional robot arm. Medical work station 1000 mayinclude a database 1014, in particular coupled to with control device1004, in which are stored, for example, pre-operative data frompatient/living being 1013 and/or anatomical atlases.

Reference is made herein to U.S. Pat. No. 8,828,023, the entire contentof which is incorporated herein by reference, for a more detaileddiscussion of the construction and operation of an exemplary roboticsurgical system.

It is contemplated, and within the scope of the present disclosure, thatother endoscopic assemblies, including a pair of jaws having a uniqueand diverse closure stroke length thereof, may be provided with a driveassembly, similar to any of the drive assemblies described herein, foraccommodating and adapting the closure stroke length for the pair ofjaws thereof to the constant trigger stroke length.

Accordingly, various endoscopic assemblies, constructed in accordancewith the principles of the present disclosure, may be provided which arealso capable of firing or forming or closing surgical clips of varioussizes, materials, and configurations, across multiple platforms formultiple different manufactures.

It should be understood that the foregoing description is onlyillustrative of the present disclosure. Various alternatives andmodifications can be devised by those skilled in the art withoutdeparting from the disclosure. Accordingly, the present disclosure isintended to embrace all such alternatives, modifications and variances.The embodiments described with reference to the attached drawing figuresare presented only to demonstrate certain examples of the disclosure.Other elements, steps, methods and techniques that are insubstantiallydifferent from those described above and/or in the appended claims arealso intended to be within the scope of the disclosure.

What is claimed is:
 1. A hub assembly for use with an endoscopicassembly of a reposable surgical clip applier, the hub assemblycomprising: an outer housing defining proximal and distal end surfaces,the proximal and distal end surfaces defining a channel therethrough; adriver gear slidably supported within the channel; a transmission gearslidably and rotatably supported within the channel; and a display gearslidably and rotatably supported within the channel, each of the drivergear, transmission gear, and display gear configured for reciprocalmovement within the channel, wherein distal advancement of the drivergear causes a corresponding distal advancement of the transmission gearand distal advancement of the transmission gear causes a correspondingdistal advancement of the display gear, wherein the transmission gear iscaused to be rotated in a first direction during each distal advancementof the driver gear and the display gear is caused to be rotated in asecond direction during a predetermined distal advancement of thetransmission gear.
 2. The hub assembly according to claim 1, wherein aportion of the channel defines a pair of opposed bosses defining anupper portion and a lower portion.
 3. The hub assembly according toclaim 2, wherein the driver gear defines a plurality of teeth on adistal portion thereof.
 4. The hub assembly according to claim 3,wherein the transmission gear defines a plurality of teeth on a proximalportion thereof, the plurality of teeth configured to selectively engagethe plurality of teeth of the driver gear to cause rotation of thetransmission gear in the first direction during engagement therewith. 5.The hub assembly according to claim 4, wherein the plurality of teeth ofthe transmission gear is configured to engage the upper portion of thepair of opposed bosses to further rotate the transmission gear in thefirst direction.
 6. The hub assembly according to claim 5, wherein thetransmission gear defines a pair of opposed teeth on a distal portionthereof.
 7. The hub assembly according to claim 6, wherein the displaygear defines a first plurality of teeth on a proximal portion thereofconfigured to engage the lower portion of the pair of opposed bosses,wherein engagement between the first plurality of teeth and the lowerportion of the pair of opposed bosses causes rotation of the displaygear in the second direction during a predetermined proximal retractionof the display gear corresponding to the predetermined distaladvancement of the transmission gear.
 8. The hub assembly according toclaim 7, wherein the display gear defines a second plurality of teeth onthe proximal portion thereof, the second plurality of teeth disposedradially inward of predetermined teeth of the first plurality of teethand configured to selectively engage the pair of opposed teeth of thetransmission gear.
 9. The hub assembly according to claim 8, wherein thesecond plurality of teeth define a pair of teeth corresponding to thepair of opposed teeth of the transmission gear.
 10. The hub assemblyaccording to claim 9, wherein each engagement of the plurality of teethof the driver gear with the plurality of teeth of the transmission gearcauses the transmission gear to rotate 1/24^(th) of a rotation in thefirst direction.
 11. The hub assembly according to claim 10, whereineach engagement of the plurality of teeth of the transmission gear withthe upper portion of the pair of opposed bosses causes the transmissiongear to rotate a further 1/24^(th) of a rotation in the first direction.12. The hub assembly according to claim 11, wherein the predetermineddistal advancement of the transmission gear corresponds to 12 of arotation of the transmission gear.
 13. The hub assembly according toclaim 12, wherein the display gear is configured to rotate 1/24^(th) ofa rotation in the second direction during engagement of the secondplurality of teeth of the display gear with the pair of opposed teeth ofthe transmission gear.
 14. The hub assembly according to claim 13,wherein the first plurality of teeth of the display gear engage thelower portion of the pair of opposed bosses during proximal translationthereof after the predetermined distal advancement of the transmissiongear, wherein engagement of the first plurality of teeth of the displaygear and the lower portion of the pair of opposed bosses causes thedisplay gear to rotate a further 1/24^(th) of a rotation in the seconddirection.
 15. The hub assembly according to claim 1, wherein an outersurface of the display gear defines a plurality of portions having acontrasting color.
 16. The hub assembly according to claim 15, whereinthe outer housing defines a plurality of windows therethrough, wherein agreater portion of each of the plurality of portions having acontrasting color is visible through each window of the plurality ofwindows after each predetermined distal advancement of the transmissiongear.
 17. The hub assembly according to claim 1, further including adisplay gear biasing element interposed between a distal surface of thedisplay gear and a proximal facing surface defined by the channel, thedisplay gear biasing element configured to bias the display gear in aproximal direction.
 18. The hub assembly according to claim 1, furtherincluding a spindle translatably supported within the channel, thespindle in selectively communication with the driver gear.
 19. The hubassembly according to claim 18, further including an overstrokemechanism disposed within a distal portion of the channel.
 20. The hubassembly according to claim 19, wherein the overstroke mechanism is inmechanical communication with the spindle, the overstroke mechanismconfigured to permit an overextension of the spindle and inhibit damageto a pair of jaws associated with an endoscopic assembly.